A fatal case of spinal tuberculosis mistaken for metastatic lung cancer: recalling ancient Pott's disease.

Annals of Clinical Microbiology and Antimicrobials
Felix C RingshausenGernot Rohde

Abstract

Tuberculous spondylitis (Pott's disease) is an ancient human disease. Because it is rare in high-income, tuberculosis (TB) low incidence countries, misdiagnoses occur as sufficient clinical experience is lacking. We describe a fatal case of a patient with spinal TB, who was mistakenly irradiated for suspected metastatic lung cancer of the spine in the presence of a solitary pulmonary nodule of the left upper lobe. Subsequently, the patient progressed to central nervous system TB, and finally, disseminated TB before the accurate diagnosis was established. Isolation and antimycobacterial chemotherapy were initiated after an in-hospital course of approximately three months including numerous health care related contacts and procedures. The rapid diagnosis of spinal TB demands a high index of suspicion and expertise regarding the appropriate diagnostic procedures. Due to the devastating consequences of a missed diagnosis, Mycobacterium tuberculosis should be considered early in every case of spondylitis, intraspinal or paravertebral abscess. The presence of certain alarm signals like a prolonged history of progressive back pain, constitutional symptoms or pulmonary nodules on a chest radiograph, particularly in the upper lobes, may...Continue Reading

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Citations

Apr 26, 2012·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Yang YuDeyu Chen
Jul 23, 2014·Clinical Neurology and Neurosurgery·Hyeong-Ki ShimSang-Ho Lee
Sep 16, 2011·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Cristopher A MeyerDanielle Seaman
Mar 7, 2012·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Chee Y ChooHaw C Lee
Sep 14, 2011·Annals of Saudi Medicine·Syed Ahmed ZakiVijoy Lad
Sep 27, 2018·Neurology·Ravindra Kumar GargShweta Pandey
Apr 14, 2016·Experimental and Therapeutic Medicine·Liang ZhangJun Cai

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Datasets Mentioned

BETA
IS6110

Methods Mentioned

BETA
PCR
biopsy

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